Dialectical Behavior Therapy (DBT)

Dialectics refers to the therapist’s ability to establish a balance between acceptance and change within their client’s therapy.

Dialectics refers to the therapist’s ability to establish a balance between acceptance and change within their client’s therapy.

DBT was widely
used to treat patients who had suicidal tendencies, were self-injurious and
suffered from Borderline Personality Disorder (BPD). It was developed by Dr.
Marsha Linehan, who lived successfully with BPD.

Dialectics refers
to the therapist’s ability to establish a balance between acceptance and change
within their client’s therapy. Like “Cognitive Behavioral Therapy (CBT)”, which
focuses on thoughts, DBT also alludes to the fact that a change of thought will
exhibit a change in feelings and behavior. However, where DBT differs is in its
emphasis on the role validation plays towards allowing troubling thoughts and
behaviors to be held in one’s consciousness. The aim is to accept those
thoughts along with the emotions mindfully and then the process of change no
longer feels impossible or restrictive.

· Mindfulness
– Becoming aware of
thoughts and feelings via bodily sensations. Patients will be able to accept
troubling thoughts, feelings, and urges (e.g. the desire to cut oneself) and
not act out on it. Patients are taught to develop 2 minds – a wise vs.
reactionary mind. They are thus taught to ask their “Wise Mind” to make better
choices for them.

· Deep
Breathing – A mindfulness
practice whereby patients can breathe into the uncomfortable sensations to let
go of the build-up of tension.

· Use
of “Homework” Between Sessions – Patients are encouraged to journal or use
“diary cards” to track their problems as well as successes.

Success of DBT

DBT has been very
successful in treating those who suffer from BPD. Suicidal outcomes for those who
suffer BPD has been reduced as a result of applying DBT. This is because the
dialectic approach fits into the “bipolar” mindset of sufferers really well.

Additionally, DBT
has also been adapted towards treating other behavioral disorders that involve
emotional dysregulation such as substance dependence (Addiction) and Binge
Eating Disorder (BED); as well as those suffering from severe depression, who
have suicidal thoughts.

Outcomes of
DBT:

With comprehensive
treatment, clients can expect the following:

1.)
Decrease
the frequency and severity of self-destructive behaviors.

2.)
Increase
the motivation to change by providing positive reinforcement.

3.)
Taught
new “coping skills” to bring back into their natural environment.

4.)
Provide
a treatment setting that emphasizes the strengths of the patient.

5.)
Enhancing
the therapy through validating therapists via group support and guidance.

Recovery:

While long-lasting
remission of problematic symptoms are expected, permanent recovery is not
ensured. There may still be problems from other areas such as self-esteem
issues and interpersonal relationships. Nevertheless, the client is expected to
live a much more meaningful life with the core symptoms of BPD, depression and
suicidal thinking resolved or stabilized. Therefore, individuals who are
involved in DBT are encouraged like everyone else to seek non-judgmental and
loving support from family and friends in their journey of recovery.